Case report of hepatic artery dissection secondary to hepatic artery pseudoaneurysm after living donor liver transplantation

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Background:
Hepatic artery pseudoaneurysm (HAP) and Hepatic artery dissection are rare vascular complications after living donor liver transplantation (LDLT), which may lead to graft loss and death of the recipients. Conventional gray-scale and Doppler ultrasound, as well as contrast-enhanced ultrasound (CEUS), play important roles in identifying vascular complications in the early postoperative period and during follow-up. We report a case of hepatic artery dissection secondary to HAP after LDLT, which was diagnosed and followed for one year by ultrasound. To the best of our knowledge, few studies have reported similar cases after liver transplantation in the English literature.

Case presentation:
A 43-year-old man underwent right-lobe LDLT for treatment of a severe acute hepatitis B infection and was followed up with ultrasound examinations for one year. Conventional gray-scale and Doppler ultrasound combined with contrast-enhanced ultrasound (CEUS) accurately revealed the occurrence of HA dissection secondary to HAP and accompanied by thrombosis and collateral circulation, as well as secondary biliary complications, which provided a prompt diagnosis and guidance for the treatment.

Conclusion:
Our case suggests that ultrasound can help detect hepatic artery pseudoaneurysm and dissection, as well as secondary biliary lesions after LDLT in an accurate and timely manner and provide useful information for the treatment chosen. CEUS shows potential as an important complementary technique to gray-scale and Doppler ultrasound.

Keywords:
Hepatic artery pseudoaneurysm, Dissection, Living-donor liver transplantation, Ultrasound, Contrast-enhanced ultrasound

Autoři: Lin Ma ¹; Kefei Chen ²; Qiang Lu ¹; Wenwu Ling ¹; Yan Luo ^1*
Působiště autorů: Department of Ultrasound, West China Hospital of Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan Province 610041, China. ¹; Department of liver and Vascular Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China. ²
Vyšlo v časopise: BMC Gastroenterology 2016, 16:44
Kategorie: Case report
prolekare.web.journal.doi_sk: https://doi.org/10.1186/s12876-016-0458-8

© 2016 Ma et al.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-016-0458-8

Souhrn

Keywords:
Hepatic artery pseudoaneurysm, Dissection, Living-donor liver transplantation, Ultrasound, Contrast-enhanced ultrasound

Zdroje

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